title: Quality of life, health care utilization, and costs among women undergoing hysterectomy in a managed-care setting.
abstract: OBJECTIVE
  We compared quality of life, utilization, and costs for women undergoing elective abdominal, laparoscopically assisted vaginal, or vaginal hysterectomy within a managed-care organization.
  
  
  METHODS
  A prospective study of 287 women who underwent an elective hysterectomy was performed.
  
  
  RESULTS
  Patients undergoing a vaginal hysterectomy reported returning to normal activity levels sooner and had more favorable quality-of-life scores than did those undergoing laparoscopically assisted vaginal hysterectomy or abdominal hysterectomy. Laparoscopically assisted vaginal hysterectomy was often nearly as favorable as vaginal hysterectomy, particularly at 28 days after the operation, whereas the abdominal hysterectomy group consistently reported the poorest postoperative quality-of-life scores. No significant differences were noted in utilization or costs in the 60-day preoperative period, whereas hospitalization and postoperative costs were highest among the abdominal hysterectomy group and lowest for those undergoing a vaginal hysterectomy.
  
  
  CONCLUSIONS
  Vaginal hysterectomy resulted in better quality-of-life outcomes and lower utilization and costs compared with laparoscopically assisted vaginal or abdominal hysterectomy.
authors.affiliation: Division of Research, Kaiser Permanente, Oakland, CA 94611-5714, USA.
authors.forename: S K
authors.initials: SK
authors.lastname: van den Eeden
authors.forename: M
authors.initials: M
authors.lastname: Glasser
authors.forename: S D
authors.initials: SD
authors.lastname: Mathias
authors.forename: H H
authors.initials: HH
authors.lastname: Colwell
authors.forename: D J
authors.initials: DJ
authors.lastname: Pasta
authors.forename: K
authors.initials: K
authors.lastname: Kunz
mesh_terms: D000328:Adult; D003362:Cost-Benefit Analysis; D004522:Educational Status; D004715:Endometriosis / Q000191:economics / Q000601:surgery; D005260:Female; D005350:Fibroma / Q000191:economics / Q000601:surgery; D017048:Health Care Costs; D006801:Humans; D007044:Hysterectomy / Q000191:economics / Q000706:statistics & numerical data*; D007045:Hysterectomy, Vaginal / Q000191:economics / Q000706:statistics & numerical data*; D007182:Income; D007407:Interviews as Topic; D010535:Laparoscopy / Q000191:economics / Q000379:methods / Q000706:statistics & numerical data*; D007902:Length of Stay; D008329:Managed Care Programs / Q000191:economics*; D017533:Marital Status; D008875:Middle Aged; D011391:Prolapse; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000191:economics / Q000601:surgery; D014594:Uterine Neoplasms / Q000191:economics / Q000601:surgery; D014932:Women's Health Services / Q000191:economics / Q000706:statistics & numerical data*